3 Things to Know About Treatment for Hallucinations

Posted By: Jimmy R Leverette Clinical Practice,
A man appears distressed and holds his face in his hands

hallucination is generally regarded as a ‘false’ perception of objects or events involving your senses: sight, sound, smell, touch and taste. In effect, hallucinations seem real, but they’re not as it pertains to others being able to experience or confirm it as well. Hallucinations can result from substance use, neurological conditions, and some temporary situations. Since research suggests between 17 and 38% of individuals experience some kind of hallucination, clinicians may want to broaden their understanding of the etiology and treatment of pathological hallucinations. So here are 3 things to know about the treatment of hallucinations in counseling. 

  1. They are not Always a Sign of Psychopathology

Although hallucinations can be a sign of a mental health illness, they do not always mean a person is unwell. Hallucinations are, in fact, relatively common. Culture does indeed have a significant impact on the experience, understanding, and labeling of hallucinations. Culture can affect what is identified as hallucinations and hallucinations are often culturally meaningful. A clinician should never assume that the report of what seems to be a hallucination is necessarily a symptom of pathology and that the patient’s cultural background needs to be considered when assessing and treating hallucinations. One of the most significant things a clinician can do is understand that culture affects the recognition of the experience of a hallucination and that this rests on the understanding of reality within that culture.


  1. There are Several Different Types of Hallucinations that People can Experience

Auditory hallucinations involve hearing sounds that others do not, like music, doors banging, or voices. Visual hallucinations involve seeing things that aren’t a part of the objective reality of others such as objects, shapes, people, lights etc. Tactile hallucinations cause you to feel sensations on your body or movement in your body. Olfactory hallucinations involve experiencing smells that that no one else can smell. Gustatory hallucinations cause tastes that are often strange or unpleasant. Presence hallucinations make you feel that someone is in the room with you or standing behind you. Proprioceptive hallucinations make you think that your body is moving, such as flying or floating, when it’s not. Somatic hallucinations affect the entire body, causing sensations to occur that seem to have no origin.


  1. Medication, ACT, and CBT Interventions may be Helpful in Treatment

Among the more difficult challenges to face as a mental health therapist is finding what therapeutic approaches are most effective for clients who experience hallucinations. Having several methods to employ and a plan in place on when to introduce them can be effective in treating hallucinations. While antipsychotic medications are often effective in diminishing symptoms, 10-60% of patients with schizophrenia respond poorly or incompletely to typical antipsychotics and 20-30% of patients taking typical antipsychotics as prescribed will relapse within the first year of maintenance treatment. Therefore, interventions that are successful in improving social behavior may prove to be beneficial in this isolated population as they may lead to increased socialization and decreased isolation.

In line with a general trend in psychological therapies, one major area of development has been the application of acceptance and mindfulness-based approaches to voices. These include mindfulness training and acceptance and commitment therapy (ACT). These interventions focus less on belief change and more on changing the relationship with internal experiences such as hearing voices. Another approach to treating hallucinations is cognitive behavioral therapy for psychosis (CBTp). Usually presented for the range of difficulties associated with psychosis rather than specifically for voices, CBTp broadly involves working at the meaning level by assisting the client in developing an adaptive understanding of their psychotic experiences.

Overall, it is important to work with clients on understanding the meaning of their hallucinatory experiences, learning ways to test them, and then developing coping strategies in conjunction with medication management, as needed, to help them lead purposeful and fulfilling lives despite these experiences.


The Oklahoma Counseling Institute may be located in the Sooner state, but we provide ACT, CBT, and IFS continuing education to Texas, Colorado, and beyond through our online catalogue! visit www.counselinginstitute.org to learn more.

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